Healing Hips, Not Replacing Them


CHICAGO, Ill. (Ivanhoe Newswire) — Hip problems are on the rise and so are hip replacements. Between 2000 and 2010, the number of hip replacement procedures more than doubled. Doctors are looking for alternatives to this major operation; especially for young, active patients. Now, a newer procedure can ease the pain for some.

Photographer Marie Christine Genero is always looking for the perfect shot. But a few years ago, hip pain prevented her from getting it.

“It was a dull, deep pain in the hip. Since I had that pain, I wasn’t going down in the positions that I usually do.” Genero explained.

She also had to give up many of her favorite activities.

“Boxing, circuit training, snowboarding, running, so just a ton of stuff that I love doing,” Genaro said.

Marie Christine had a femoroacetabular impingement or FAI for short. It happens when bones in the hip change shape and rub together, and is commonly seen in young, active people.

“So, the ball and socket kind of change shape in response to repetitive activities and loadings that’s going on in the joint.” Shane J. Nho, MD, MS, an Orthopedic Surgeon at Midwest Orthopaedics at Rush told Ivanhoe. (Read Full Interview)

Doctor Nho performs a procedure called hip arthroscopy to solve the problem. First, he makes tiny incisions and repairs any damage. Then, he works on the abnormal bone shape.

“Most importantly, we have to shave down the bone so that the ball and socket articulate more smoothly.” Dr. Nho explained.

The surgery only takes about an hour and a half, but the recovery can be six months or more! Doctor Nho says because the procedure is newer, the long-term outcomes aren’t known. The hope is that arthroscopy can prolong the need for a hip replacement in young patients.

Marie Christine had the procedure about nine months ago, and now, she can snap away!

Doctor Nho says hip arthroscopy is considered a newer procedure, and not all doctors are trained to perform it. For more information on the surgery, go to hipsforlife.org.

Contributors to this news report include: Cyndy McGrath, Supervising Producer; Julie Marks, Field Producer; Gabriella Battistiol, Assistant Producer; Roque Correa, Editor.

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REPORT:       MB #4293

BACKGROUND: In a healthy hip, a thin tissue membrane surrounds the hip joint and creates a small amount of fluid that lubricates the cartilage and eliminates friction during hip movement. Ligaments connect the ball to the socket and provide stability to the joint. Femoroacetabular impingement is a condition where extra bone grows along the bone that forms the hip joint. Because they do not fit perfectly, the bones rub against each other during movement and this friction can damage the joint, causing pain and limiting a patient’s activity. There are three types of FAI; pincer, cam, and combined impingement. Pincer occurs when the extra bone extends over the normal rim of the acetabulum, resulting in the labrum being crushed. Cam happens when the femoral head is not round and cannot rotate smoothly, causing a bump to form on the edge of the head that grinds the cartilage. Finally, combined means that both the cam and pincer types are present.

(Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00571)

TREATMENT: Since there is no absolute age or weight restrictions for a total hip replacement, recommendations for the surgery are based on pain and disability. Most patients who undergo the surgery range from age 50 to 80. Surgery is recommended for patients with the following symptoms; hip pain that limits everyday activities like walking, pain that continues while resting day and night, stiffness that limits the ability for a patient to move or lift their leg, and failure to suppress pain with anti-inflammatory drugs, physical therapy, or walking support. Orthopaedic evaluation for a total hip replacement surgery may include medical history, a full physical examination, X-rays and other tests such as MRI scans.

(Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00377)

HIP ARTHROSCOPY: Hip arthroscopy may be an alternative to a total hip replacement, especially for young and/or active patients. It is a surgical procedure that allows doctors to examine the hip joint without making a large incision through the skin and other soft tissue. A surgeon performing this procedure inserts a small camera into the hip joint. Then using miniature surgical instruments, a surgeon will identify and evaluate the damage before beginning any specific treatments. Once the problem is clearly identified, more instruments will be used through separate incisions to repair it. Procedures can include smoothing off torn cartilage or repairing it, trimming bone spurs caused by FAI, and removing inflamed tissue. Special instruments are used for tasks such as cutting, shaving, grasping, suture passing and knot tying as well as anchor stitches into the bone. Complications are very uncommon, recovery can take upwards of 6 months.

(Source: http://orthoinfo.aaos.org/topic.cfm?topic=A00572)


Lisa Stafford


If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Doctor Q and A

Read the entire Doctor Q&A for Shane J. Nho, MD, MS

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